Bilingual Medicaid Enrollment Specialist

WelbeHealth, LLC.; Newark (NJ); Hybrid; USD 39,000 - 51,000; Full time

Benefits offered by this job

Medical insurance

401K match

PTO + holidays

Advancement opportunities

Diversity & inclusion

Job summary

WelbeHealth, LLC. is seeking a Medicaid Enrollment Specialist to join our Outreach and Enrollment team in Newark, NJ. This role focuses on enrolling prospective participants in Medi-Cal and supporting the enrollment workflow across DPSS interactions.

The ideal candidate has a Bachelor’s degree (preferred), 3+ years experience with Medi-Cal enrollments, and is bilingual in Spanish and English. You will gather documentation, visit seniors at home, and help run enrollment events across centers,

Qualifications

• Bachelor’s degree in a relevant field preferred; five years of Medicaid enrollment experience may substitute.
• Bilingual Spanish/English strongly preferred.
• Minimum of three years experience with county DPSS submitting, managing, and appealing Medi-Cal enrollments.
• Demonstrated knowledge and experience with complex Medicaid enrollment case management.

Responsibilities

• Gather documentation to create, submit, and appeal Medi-Cal enrollments.
• Visit seniors' homes as needed to collect documents for complete applications.
• Maintain relationships with DPSS to ensure compliance and timely enrollment workflows.
• Create and conduct Medicaid enrollment events weekly at WelbeHealth centers, monthly at senior housing, hospitals, senior centers, churches, and monthly virtual sessions.
• Demonstrate knowledge of Medicaid rules, processes, options to enroll including share of cost and appeals.

Skills

Bilingual Spanish/English

Medicaid enrollment experience

Case management knowledge

Documentation gathering

Education

Bachelor’s degree

Job description

At WelbeHealth, our Outreach and Enrollment Team is the first touchpoint prospective participants have with us. A vital part of WelbeHealth’s PACE enrollment process is aiding those who qualify with the Medi-Cal Enrollment process.

The Medicaid Enrollment Specialist focuses on successfully enrolling prospective participants in Medicaid. The Medicaid Enrollment Specialist is a member of the Marketing, Outreach, and Enrollment (MOE) team and provides back-up and support to Outreach and Enrollment functions as assigned.

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies (for example, marketing guidelines and denials policies)
• Create and conduct Medicaid enrollment events to attract prospective participants:
  • Every week in each of the WelbeHealth centers in territory
  • Monthly at senior housing, hospitals, senior centers, churches
  • Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medicaid rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Job Requirements:

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medicaid enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred
• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments
• Demonstrated knowledge and experience with complex Medicaid enrollment case management

Benefits of Working at WelbeHealth: Apply your coding expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical insurance coverage (Medical, Dental, Vision)
• Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and sick time
• 401K savings + match
• Advancement opportunities - we’ve got a track record of hiring and promoting from within, meaning you can create your own path!
• And additional benefits

Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.

$28.23 - $37.27 USD

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

Beware of Scams

Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to [e-mail]

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Do you have recent experience with Medicaid enrollments? * Select...

Are you bilingual and if so, in which language are you fluent in? *

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For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in WelbeHealth’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

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An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.